<div class="pageContent">
    <form method="post" action="{:U($module_name.'/bank')}" class="pageForm required-validate" onsubmit="return validateCallback(this,dialogAjaxDone);">
        <div class="pageFormContent" layoutH="97">                 
            <fieldset>
                <legend>
     
                </legend>
			   <dl>
                <dt>
                    用户名：
                </dt>
                <dd>
                	<input id="inputBrand1" name="user.id" value="{$info.userid}" type="hidden"/><input class="required autoinput" name="user.username" value="{$info.username}" type="text" postField="keywords" suggestFields="id,username" suggestUrl="{:U('User/suggest',array('tn'=>'user','fn'=>'id,username','field'=>'id,username','where'=>myencode(array('status'=>1),1)))}" lookupGroup="user"/>                 
                </dd>
            </dl>
                <dl style="height:20px;">
                    <dt>
                        充值金额：
                    </dt>
                    <dd style="width:230px;">
                        <input type="text" class="required input-text"  id="give" name="price" value="">&nbsp;CV
                    </dd>
                </dl>
                <dl style="height:20px;">
                    <dt>
                        账单编号：

                    </dt>
                    <dd>
                        <input type="text" id="liushuisn" name="liushuisn" value="" class="input-text"   />&nbsp;
                    </dd>
                </dl>
            </fieldset>
 
  
        </div>
        <div class="formBar">
            <ul>
                <li>
                    <div class="buttonActive">
                        <div class="buttonContent">
                            <button type="submit">
                                保存
                            </button>
                        </div>
                    </div>
                </li>
                <li>
                    <div class="button">
                        <div class="buttonContent">
                            <button type="button" class="close">
                                取消
                            </button>
                        </div>
                    </div>
                </li>
            </ul>
        </div>
    </form>
</div>
	